Kornimate/medical-research-clean huggingface dataset:
diagnostic algorithm in suspected upper extremity deep vein thrombosis

Conditions: Suspected Upper Extremity Deep Vein Thrombosis

Summary: deep vein thrombosis (dvt) of the arm, officially called upper extremity dvt is a rare disorder and accounts for up to 1-4% of all cases of deep vein thrombosis. in case of a thrombosis, there is a blood clot in one of the veins, which should be treated with blood thinners (anticoagulants). the aim of the present study is to see whether it is safe to use a combination of tests for the diagnosis of arm thrombosis. in all patients, we will use a clinical decision rule (clinical judgement) and a laboratory test (d-dimer testing), in most patients also an ultrasound of the arm will be done. the combination of these tests was found to be safe and effective in patients with thrombosis of the legs.

consecutive patients with clinically suspected upper extremity deep vein thrombosis (uedvt) are potentially eligible for the study. patients will be categorized as likely or unlikely to have uedvt based on a clinical decision rule (cdr). patients "unlikely" for uedvt based on the cdr and with normal d-dimer levels will not receive anticoagulant treatment and will be followed-up for 3 months. all patients with a likely cdr or patients with an unlikely cdr combined with elevated d-dimer levels will undergo ultrasonography. in case of an indeterminate ultrasonography result, ultrasonography testing will be repeated 3-5 days later. the same applies for patients with a negative ultrasound and the combination of a high probability and elevated d-dimer levels. anticoagulants will be withheld in all patients for whom uedvt will be excluded by the initial diagnostic work-up.

Eligibility criteria:
inclusion criteria: * patients from the emergency department, in and out patient clinic with clinically suspected upper extremity deep vein thrombosis exclusion criteria: * no informed consent obtained * legal age limitation (country specific) * use of anticoagulants in therapeutic dosages longer than 24 hours prior to randomisation * prior vein thrombosis in the same arm * life expectancy \< 3 months * haemodynamic instability * previous participation in the study

Keywords: suspected upper extremity deep vein thrombosis diagnostic algorithm
"real life" evaluation of efficacy and safety of direct antiviral agents (daas) for the treatment of hepatitis c virus in egypt

Conditions: Chronic Hepatitis C

Summary: the primary purpose of the anrs 12332 hepnile study cohort is to assess in "real-life" condition the efficacy and the safety profile of new direct acting antivirals (daas) introduced in the egyptian national treatment programme for the treatment of chronic hepatitis c (chc).

clinical trials are performed under optimal conditions where patients are highly selected with no co-morbidity, clinical supervision is provided by the best specialists in the field, and strict protocols are used to enhance patients' compliance. thus, results may not be generalizable to real-world clinical practice. observational studies are now gaining attention, showing with previous treatments (combined pegylated interferon and ribavirin) a wide range of results in terms of treatment effectiveness (svr from 21% to 63% overall), whereas related pivotal clinical trials had estimated svrs between 54% and 63% overall. egypt is the first low/middle-income country where a national treatment program has been established on a large scale, allowing an evaluation that might be useful to itself and other similar countries. a real life evaluation will be particularly relevant now that new anti-viral drugs, direct-acting antivirals, are being introduced in egypt. anrs 12332 hepnile cohort study will allow "in real life condition" the study of: * efficacy (cure rate) and safety of new hcv regimens introduced in egypt * emergence of resistance variants for patients with virological breakthrough * factors associated with treatment failure * drug-drug interactions * adherence to the treatment regimens

Eligibility criteria:
inclusion criteria: * hcv rna positivity * 18 years =\< age =\< 70 years * patients \>= 65 years should undergo cardiological assessment prior to therapy by ecg echocardiography and cardiological consultation * effective contraception (women of childbearing potential should use an effective contraception; male patients and their female partners must also practice effective contraception) both during treatment and for the 3-months post-therapy); no breast-feeding * signed informed consent and willingness to participate in the study exclusion criteria: * child c cirrhotic patients * platelet count \> 50000/mm3 * hepatocellular carcinoma (hcc), except 6 months after intervention aiming at cure with no evidence of activity by dynamic imaging (ct or mri) * extra-hepatic malignancy except after two years of disease-free interval (in case of lymphomas and chronic lymphatic leukemia, treatment can be initiated immediately after remission) * pregnancy or inability to use effective contraception * inadequately controlled diabetes mellitus (hba1c\>9%)

Keywords: hepatitis c, genotype 4, daas, real life evaluation
effect of rifaximine on sleep disorders in patients suffering from hepatic encephalopathy

Conditions: Hepatic Encephalopathy

Summary: hepatic encephalopathy is responsible for sleep disturbances and daytime sleepiness. the purpose of our study is to assess sleep quality, quantity, sleep schemes and physical activity in patients suffering from he, before and after a 2 weeks treatment with rifaximine, which is currently given to lower blood ammoniac levels.

hepatic encephalopathy (he) is a complex neuropsychiatric syndrome related to chronic/acute hepatic failure. sleep architecture is disturbed in this syndrome, and patients complain mainly of excessive daytime sleepiness and sleep disturbances. hypothesis to explain these symptoms is, among others, disturbed melatonin metabolism. few studies have been conducted in order to study sleep disorders during he, and effect of treatment is unknown. recently, rifaximine, an oral broad spectrum antibiotic, have been proved to decrease ammoniac production in patients with he. the purpose of our study is to assess sleep quality, quantity, sleep schemes and physical activity in patients suffering from he, before and after a 2 weeks treatment with rifaximine.

Eligibility criteria:
inclusion criteria: * \>18y hepatic encephalopathy: positive conn score exclusion criteria: * \<18y pregnancy inability to fulfil questionnaires acute infection unstable clinical condition bone or articular disease resulting in significant disability

Keywords: sleep quality physical activity daytime sleepiness actigraphy quality of life
prolove - prospective randomized study of midline incisional hernia treatment

Conditions: HERNIA, VENTRAL

Summary: this purpose of this study is to compare the recovery after an operation of an incisional hernia within the limits of the rectus muscles of the abdominal wall. the use of a mesh in the repair of a postoperative hernia is considered obligatory. placement of a retromuscular mesh is done by open or laparoscopic surgery. focus is on the recovery phase assuming a less painful recovery after a laparoscopic procedure.

incisional ventral hernia after abdominal surgery is a fairly common condition. in recent years the use of a prosthesis in the repair procedure has proved very effective in preventing a new hernia. a retromuscular mesh placement seems to have superior results. the mesh may be placed retromuscular through an open surgical procedure or through a laparoscopic procedure in an intra-abdominal position. both procedures are highly standardized. a heavy weight mesh is used in the open procedure, fixed in the midline only, and a composite mesh is used intraabdominally and fixed only with titanium tackers. sf-36 is used to assess the quality of life, and its subscale bp (bodily pain) is used as primary outcome 3 weeks postoperatively. secondary endpoints are return to daily life, pain, complications, recurrence, patient satisfaction and cosmetic outcome. subjects are assessed at 1,3,8 weeks post operation and after 12 months.

Eligibility criteria:
inclusion criteria: * age over 18 years * postoperative hernias in the region of the recti abdomini muscles with a defect of less than 10 cm transversal width * no contraindications to laparoscopic procedure * the patient should be able to adequate ventilation/respiration after reduction of hernia contents * indications for elective surgery exclusion criteria: * pregnant women * prior operation of abdominal hernia with mesh placement in the compartment of the rectus abdominus muscle (i.e. prior onlay mesh is acceptable) * need of an interpreter * current drug abuse, mental disorder or other condition which makes the patient incapable of postoperative follow up * body mass index (bmi) \>40 * other planned concurrent operation * current oral steroid treatment, or other immune system modulating treatment * incarcerated incisional hernias * parastomal hernias * prior history of open abdomen * enterocutaneous fistula or cutaneous infection * hepatic cirrhosis or ascites * generalized malignancy * history of radiation treatment in the abdomen. * asa \>iii

Keywords: ventral hernia incisional hernia
prevalence of vertebral fractures in patients with type 1 diabetes

Conditions: Diabetes Mellitus, Type 1; Bone Fracture; Bone Health

Summary: background : type 1 diabetes is associated with an increased risk of fractures. the mechanisms accounting for this bone fragility are not yet fully understood. the lower bone mineral density (bmd) observed in individuals with type 1 diabetes cannot solely explain the higher fracture incidence. bone microarchitecture defects significantly contribute to bone fragility. few studies assessed spine fractures in type 1 diabetes. this cross-sectional multicenter case-control study aims (1) to evaluate the prevalence of asymptomatic vertebral fractures in individuals with type 1 diabetes in comparison to age- and sex-matched healthy controls; (2) to compare individuals with diabetes with vertebral fractures and those without vertebral fracture using clinical, biochemical and radiological parameters.


Eligibility criteria:
individuals with type 1 diabetes inclusion criteria: * diagnosis of type 1 diabetes for at least 5 years; * age 20 years and older. exclusion criteria: * pregnancy or breastfeeding; * conditions associated with bone disease (significant liver disease, intestinal malabsorption other than celiac disease, organ transplant, active cancer, rheumatoid arthritis, hyperthyroidism, hypothyroidism with abnormal thyroid-stimulating hormone (tsh), hyperparathyroidism, hypoparathyroidism, acromegaly, cushing syndrome, adrenal insufficiency); * any of these medications in the past 6 months : glucocorticoids ≥ 7,5 mg prednisone/day or equivalency ≥ 3 months, aromatase inhibitors, antiandrogens, antiepileptic drugs, anticoagulants, sodium-glucose cotransporter-2 (sglt-2) inhibitors, thiazolidinediones; * past medical history of traumatic vertebral fracture; * inability to consent. healthy controls inclusion criteria: * age 20 years and older. exclusion criteria: * as above (as individuals with diabetes), and : * diagnosis of diabetes or prediabetes; * celiac disease; * chronic kidney disease (crcl \< 60 ml/min); * any of theses medications in the past 6 months : biphosphonates, teriparatide, denosumab, calcitonin; * past medical history of fragility fracture.
drug interaction between paracetamol and warfarin

Conditions: Deep Venous Thrombosis; Pulmonary Embolism; Atrial Fibrillation; Stroke; Antiphospholipid Syndrome

Summary: the objective of this study is to investigate whether paracetamol, given at therapeutic doses (2g/day and 3 g/day), may potentiate the anticoagulant effect of warfarin.

paracetamol is recommended as a first-line analgesic and antipyretic therapy in patients receiving short- and long-term oral anticoagulation, especially elderly patient.however,increased inr was previously observed in patients treated with warfarin and paracetamol given at the maximum recommended dose (4g/day). to date, the mechanism of this interaction has not been determined.a recent in vitro study suggested that the toxic metabolite n-acetyl-para-benzoquinoneimine (napqi) appeared to interfere with vitamin k-dependent γ-carboxylase (vkd-carb) and vitamin k epoxide reductase (vkor) activites12. the question remaining to be dealt with is whether this in vitro observation can explain the in vivo paracetamol-warfarin interaction. we aim to evaluate the effect of paracetamol at the most widely used doses 2 and 3g/day on inr in stable patients treated with warfarin in a double blind randomized placebo-controlled trial and to identify the mechanism involved in this interaction in vivo.

Eligibility criteria:
inclusion criteria: * patients treated with warfarin (target inr 2 to 3) stable anticoagulation at 2 to 9 mg for more than 30 days * aged 18 years or older * laboratory values (hemoglobin, blood cell counts, albumin, blood ionogram, complementary hemostasis parameters and aspartate, alanine transaminases (ast and alt))remained within normal limits exclusion criteria: * any treatment change within 7 days before enrollment * any paracetamol intake within the last 14 days * drug allergy concomitant drug ( 5-fluorouracile, acetylsalicylic acid, non steroidal anti-inflammatory drugs, chloramphenicol, diflunisal, miconazole) * st john's wort treatment * pregnancy

Keywords: paracetamol warfarin drug interaction pathogenic mechanism
prediction of post-stroke motor recovery

Conditions: Stroke; Upper Limb Motor Deficit

Summary: the prediction of motor recovery in the acute phase of stroke is crucial for several clinical reasons: (i) informing the patient and his relatives, (ii) helping to identify the patient's endorsement (return home or rehabilitation) as well as the adaptation of the rehabilitation program to what can be expected from it. to date, an algorithm (decision tree) proposed by c. stinear's team named prep2 is the best predictive tool with 75% of patients well classified at 3 months. it predicts the functional recovery of the upper limb after stroke 3 months before the episode by categorizing recovery as "excellent", "good", "limited" as well as "minor" (poor). with two data (safe score, age) or three (safe score, motor evoked potential, nihss), the prediction is effective three times out of 4. in the study the team is proposing "prep-ucv", it would like to validate this algorithm as it is with patients in the active file who are victims of stroke. the expected accuracy is 75% or more. as a secondary objective, the team would like to confirm that it find the same algorithm starting from the initial data from prep 2 (side of the stroke, type of stroke (ischemic and / or hemorrhagic), involvement of the corticospinal tract on mri, sex at birth ) as well as two other factors which are also very important: cognitive status (dysexecutive / aphasia / neglect), as well as the neutrophils on lymphocytes ratio.

retrospective cohort of stroke patients with a upper limb deficit.clinical scores such as safe score, nihss; demographic data such as age and electrophysiological data (such as the absence/presence of motor evoked potential) will determine the predictive functional outcome of the upper limb deficit according to the prep2 algorithm. the accuracy of this prediction will be verified according to the actual state of the patient at 3-6 months. second, another algorithm will be built taking in account cognitive deficits and biological data to determine if the accuracy is higher. all data will be acquired during the clinical routine work-up.

Eligibility criteria:
inclusion criteria: * age ≥ 18 y-o, * admitted in the pitié-salpêtrière stroke unit, * stroke with a upper limb motor deficit, * agree to participate; exclusion criteria: * contra-indication to mri or tms, * patients under legal guardianship , * patients without healthcare insurance

Keywords: stroke motor prediction
evaluation of effect of integrated treatment by traditional chinese and western medicine for severe acute pancreatitis

Conditions: Pancreatitis, Acute Necrotizing

Summary: with multicenter randomized control clinical evaluation investigations, the scheme of integrated medicine treatment of severe acute pancreatitis (sap) was further improved, and the therapeutic effects, safety and indications assured. drawing in latest research fruits at home and abroad, a clinical practical guideline for integrated medicine of diagnosis and treatment of sap would be formed, to be popularized all over china.


Eligibility criteria:
inclusion criteria: * adult patients 18yr-70yr, complying with the diagnostic standard of acute pancretitis (clinical symptoms and signs, elevated blood and urine amylase, and imaging criteria), conforming to 3 or more ranson's criteria and apache-ii score larger than 8, balhazar ct score larger than 5. exclusion criteria: * pregnancy, nursing mother, critical cases of advanced tumor, on the verge of death (estimated to be moral in 12h), severe visceral function disturbance, patients undergoing other therapeutic research that might interfere with the present study.
effect of protein consumption and resistance training on body composition, muscular strength and functional capacity in the elderly

Conditions: Elderly; Sarcopenia

Summary: the increase in life expectancy of the world population is associated with a higher incidence of diseases, leading to functional incapacity and dependence in old age. aging is usually accompanied by progressive loss of muscle mass, muscular strength and functional capacity, possibly exacerbated by inactivity and low protein and energy consumption of elderly individuals. however, the response to strength training, as well as the daily recommendation of protein and other factors related to sarcopenia in this population seem not to be well understood. objective: to evaluate the effect of protein intake and resistance training on body composition, muscle strength and functional capacity in the elderly. methods: a randomized placebo-controlled clinical trial will be conducted with 38 elderly people, ≥ 60 years old, sedentary, and body mass index between 22 and 30 kg / m2. all those who agree to participate will be randomized into two groups (intervention or placebo) and will undergo an initial assessment consisting of food consumption analysis through the application of the three-day food record, assessment of muscle thickness of the thigh and arm by muscle ultrasonography, evaluation of body composition by dual energy x-ray absorptiometry (dexa), dynamic maximal strength (1rm) test of knee extension and elbow flexion, peak torque test of knee extension, functional capacity tests and quality of life questionnaire (sf-36). the elderly will participate in resistance training for 12 weeks, two session per week. the intervention group will be supplemented with whey protein isolate (2x / day - 20g for breakfast and 20g for dinner) and the placebo group will receive maltodextrin (2x / day - 20g for breakfast and 20g for dinner). all outcomes will be assessed before and after the 12-week resistance training period.


Eligibility criteria:
inclusion criteria: * be 60 or older, and in the case of women, they must be postmenopausal (interruption of menstruation for more than one year). * have not participated in any systematic exercise program for at least six months prior to the start of this project. * to have a body mass index (bmi) between 22 and 30 kg / m2. * are not cardiopathic, diabetic or have any other metabolic disease. * do not present joint problems or any other injury that prevents the proper execution of the exercises of the training routine. * non-smoker or have quit smoking for at least five years ago. * release of the doctor (medical certificate) to perform the physical exercises. exclusion criteria: * do not participate in at least 20 training sessions or miss more than three consecutive training sessions.

Keywords: protein supplementation body composition resistance training functional capacity muscle strength
glucose pattern in infertile women receiving assisted reproduction using continuous glucose monitoring

Conditions: Infertility Female

Summary: no studies have been seen on glucose variation during medication for assisted reproduction. the aim of this study is to continuously observe glucose variation during assisted reproduction treatment using continuous glucose monitoring (cgm), and to further explore whether glucose variation will affect the outcomes related to assisted reproduction.

infertility is a growing global health concern and affects approximately 20% of couples of reproductive age. as a result, the use of assisted reproductive technologies (art) is becoming more prevalent. this study could serve as a basis for the interpretation of glucose levels with respect to these people undergoing art regimen. moreover, the success rate of art still needs to be further improved. key challenges include optimizing the hormonal components of art regimens and determining the ideal treatment duration. this study might provide insights into the potential benefits of monitoring glucose levels at specific points during art cycles (which is not usually performed in routine practice) and help clinicians tailor art regimen to minimize glucose variation, ultimately improving clinical pregnancy and live birth rates. additionally, the findings might support integrating cgm into the clinical practice of art, enhancing individualized patient care.

Eligibility criteria:
inclusion criteria: 1. informed consent and voluntary participation in this study; 2. age ≥ 18 years and ≤40 years old; 3. infertile patients who will undergo their first or second cycle of in vitro fertilization/intracytoplasmic sperm injection (ivf/icsi) at the study center; 4. the chosen ovulation promotion regimens is the gnrh antagonist regimen/progesterone-promoting ovulation under hyperprogesterone state (ppos) regimen. exclusion criteria: 1. recent infections (excluding viral infections of the reproductive system such as hpv); 2. recent glucocorticoid treatment or chemotherapy; 3. clinical conditions affecting the outcome of assisted reproduction, including repeated implantation failure, recurrent spontaneous abortion, history of unilateral oophorectomy, uterine malformations, and parental karyotype abnormalities; 4. participants were unable to tolerate tape adhesive around sensor placement area, or with medically documented allergy towards the adhesive (glue) of plasters, or with serious skin diseases (e.g. psoriasis vulgaris, bacterial skin diseases) around sensor placement area.